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Hypertensive disorders of pregnancy

BMJ 2017; 358 doi: (Published 13 July 2017) Cite this as: BMJ 2017;358:j3245
  1. Helen L Barrett, acting clinical director and research fellow1 2,
  2. Leonie K Callaway, professor and obstetric physician1 2
  1. 1Obstetric Medicine, Royal Brisbane and Women’s Hospital, Brisbane, Australia
  2. 2UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Australia
  1. Correspondence to: L K Callaway l.callaway{at}

An opportunity to begin lifelong control of cardiometabolic risk factors

In this issue of The BMJ the question of the long term follow-up for women with hypertensive disorders of pregnancy is examined in two substantial datasets: a nationwide cohort in the Danish study by Behrens and colleagues (doi:10.1136/bmj.j3078)1 and data from the Nurses’ Health Study II in the trial by Timpka and colleagues (doi:10.1136/bmj.j3024).2 Taken together these two studies tease out some of the complexities underlying the development and long term impact of hypertensive disorders of pregnancy and the relation between these disorders and general cardiometabolic risk factors. The findings emphasise the need to recognise as a lifelong risk factor any episode of gestational hypertension, pre-eclampsia, eclampsia, or HELLP syndrome.

Both studies confirm other recent cohort studies3 suggesting that risk factors for hypertensive disorders of pregnancy are present before conception. Participants in the Nurses’ Health Study II who subsequently developed a hypertensive disorder of pregnancy had a …

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